title: Association of age at menarche with increasing number of fibroids in a cohort of women who underwent standardized ultrasound assessment.
abstract: Age at menarche has been associated with several reproductive conditions, and frequencies differ by race. Racial disparities also impact fibroid risk. We comprehensively examined the relationship between age at menarche, fibroid characteristics, and race. Women were enrolled in Right From the Start (2001-2010), a multistate study that systematically screened for fibroids during very early pregnancy. Endovaginal ultrasounds were conducted, and fibroid presence, number, type, volume, and diameter were recorded according to standardized definitions. Generalized estimating equations adjusted for correlations within study site were used to estimate associations between age at menarche and fibroid status and to test for interactions with race. Of 5,023 participants, 11% had a fibroid. Seven percent underwent menarche before 11 years of age and 11% at 15 years or later. We did not observe interactions between age at menarche and race. A 1-year increase in age at menarche was inversely associated with fibroids (adjusted risk ratio = 0.87, 95% confidence interval: 0.82, 0.91). Early age at menarche had a similar positive association in individual analyses with fibroid size, type, and location but was stronger for multiple fibroids (adjusted risk ratio = 0.75, 95% confidence interval: 0.68, 0.83). Our findings confirm other reports of an association between age at menarche and fibroid development (regardless of characteristics), demonstrate no effect modification by race, and suggest a stronger association for women with multiple fibroids, possibly reflecting a stronger association for early-onset disease.
authors.affiliation: Vanderbilt Epidemiology Center, Institute of Medicine and Public Health, Department of Obstetrics and Gynecology, Vanderbilt University, Nashville, Tennessee 37203, USA. digna.r.velez.edwards@vanderbilt.edu
authors.forename: Digna R
authors.initials: DR
authors.lastname: Velez Edwards
authors.forename: Donna D
authors.initials: DD
authors.lastname: Baird
authors.forename: Katherine E
authors.initials: KE
authors.lastname: Hartmann
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D017668:Age of Onset; D002648:Child; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007889:Leiomyoma / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D008487:Medical History Taking; D008572:Menarche / Q000208:ethnology*; D009657:North Carolina / Q000453:epidemiology; D015995:Prevalence; D013714:Tennessee / Q000453:epidemiology; D013781:Texas / Q000453:epidemiology; D014463:Ultrasonography; D014594:Uterine Neoplasms / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D055815:Young Adult
keywords: age at menarche; epidemiology; fibroids; uterine leiomyoma